United Lincolnshire Hospital Trust Board Meeting Public Session

United Lincolnshire Hospital Trust Board Meeting Public Session took place on 7 February 2017 at Lincoln Hospital.

At the meeting ULHT proposed to open Grantham A & E for one more hour every morning, after 6 months of night time closures. ULHT board members confirmed Grantham A&E admissions protocols, which include the assessment, stabilisation and resuscitation of acutely ill patients, supported by middle grade and consultants, will remain in place.

The board meeting was attended by Grantham Councillors Linda Wootten (Mayoress of Grantham), Ray Wootten, Charmaine Morgan (Chair SOS Grantham Hospital), and Mark Whittington whose questions were read out by Dean Fathers at the beginning of the meeting. Members of Fighting4 Grantham Hospital also attended the meeting.

The new hours proposed will be between 0800-1830 instead of 0900-1830.

Local campaigners felt the proposal to be wholly inadequate and feel totally let down by ULHT and those on the board who are meant to represent the public. Grantham Hospital A&E remains closed during the busy evening period and at night when there is no public transport.

The decision was based on fragmented incomplete data and ignored the needs of residents/visitors to the Grantham Hospital catchment area. It gave little weight to the impact on other parties.

Given the poor performance record of East Midland Ambulance Service (EMAS), who are badly affected by issues at Lincoln A&E department, the continued EMAS support for Grantham A&E night closure was considered particularly inappropriate by campaigners.

No mention was made in the report of the impact on Nottingham, Peterborough or Leicester hospitals, where people south west of Grantham may go instead of Lincoln when Grantham A&E is closed. ULHT should be monitoring the complete Grantham Hospital catchment area. Those most rural with furthest to travel are most at risk in an emergency.

EMAS representative stated only 6-7 cases a night from our area use 999 ambulances. This is a significant number when considering each case could easily take 2.5hours to handle – excluding time waiting outside hospital.

11policing hours a week are lost as Police must escort those in custody needing medical attention to A&E. As Police and PCSO numbers are cut locally, any impact on Police resource is of concern and could have public safety implications.

There was no mention of the impact on Lincolnshire Fire & Rescue Service or Lincolnshire Integrated Voluntary Emergency Service (LIVES) who are on the front line as well in a medical emergency.

Statistics on their own mean nothing if not put into context and some are misleading.

According to ULHT only one complaint was received relating to Grantham A&E night closure. However campaigners noted ULHT ignored or gave little weight to the qualitative evidence on the Fighting4 Facebook group and statements provided in reports from SOSGH.

Campaigners personally witnessed children with fractured limbs being forced to travel at least 40km further when Grantham A&E first closed, and, a patient who died in transit from heart failure shortly after the closure. The incidents were brought to the attention of ULHT members at the time.

There was no mention of the case referred to ULHT of a man found lying at the entrance to Grantham A&E in -2 degrees centigrade in the middle of the night before Christmas which SOSGH reported to the Care Quality Commission (CQC) who asked ULHT to investigate.

It is clear anyone suffering as a result of the Grantham A&E night closures must use the ULHT complaint process or their voice will not be heard. Delays in receiving treatment are particularly relevant/concerning. The ULHT online complaint process can be found here.

We also ask that this information is shared with SOSGH so we can monitor the situation.

ULHT are also considering by-passing Grantham A&E and admitting elderly sick patients directly into Grantham Hospital in future. Any measure that keeps the care of vulnerable patients local is welcome. However, such a move would further undermine the future viability of Grantham A&E, which is seeing a decline in attendances since the night closure. The Sustainability and Transformation Plan’s (STP) cost cutting proposals would see A&E services centralised across the county.

Cllr Morgan said:

There is no clear holistic record of the impact of the closure of Grantham A & E on patients. There is however evidence to show that since the closure of Grantham A&E at night the situation at Lincoln A&E has not improved. Whe nGrantham A&E was closed without public consultation by ULHT in August 2016the need to improve patient safety at Lincoln was the reason provided. In effect the ULHT strategy has failed – point that has not escaped the attention of campaigners.

By looking at acute care in isolation it is possible ULHT are not focusing on the real issue.

There is a shortage of hospital beds at Lincoln County Hospital, which is working to capacity and is over-stretched. This is causing delays in admissions from A&E with a knock on effect to EMAS ambulance crews and the patients they carry. Any further reduction in hospital beds needs to be challenged locally and nationally. Sending more patients to Lincoln can only worsen the situation. A fact Lincs Health And Care should consider when looking at the Sustainability and Transformation Plans.

As ULHT will not re-open our unit we must now await Jeremy Hunt’s decision – the case was referred to him by Lincolnshire County Council. The council voted unanimously for Grantham A&E to be re-opened.

Given this it is very concerning that recently Phillip Dunne MP Minister for Hospitals described Grantham Hospital as a Level 3 A& E. ULHT have sent confusing messages about the role of our A&E which are affecting decision makers.

A focus on the national issue regarding the inadequate support for people with mental health issues is needed too. When all else fails a local A&E is the only safety net available. Grantham A&E can save lives – when it is open.

Following the meeting SOSGH are progressing a complaint to the Parliamentary & Health Services Ombudsman.

SOSGH are running workshops to see what health services local people need.

SOSGH members will be joining the Fighting4 protest march in Grantham on 25th February at 11:00 St Peters Hill. People will have a final chance to sign our petition opposing the downgrade of Grantham Hospital A&E. The petition is approaching a 50,000 signature target.

SOSGH also encourage as many local people as possible to join them on 4 March in London at the Keep Our NHS Public protest, which is meeting at 12noon Tavistock Square. The GMB are providing a coach from Grantham for members. Details of the protest including how to book a place on a coach from Grantham coach can be found on the KONP website.